Basic Information
| Provider Information | |||||||||
| NPI: | 1003800764 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 885 | ||||||||
| Address2: | |||||||||
| City: | ABBEVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296200885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643666060 | ||||||||
| FaxNumber: | 8644595719 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 W GREENWOOD ST | ||||||||
| Address2: | SUITE 8-A | ||||||||
| City: | ABBEVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296205678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643666060 | ||||||||
| FaxNumber: | 8644595719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 08/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 08/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 8413 | SC | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | CC5830 | 01 | SC | RAILROAD MEDICARE | OTHER | 084134 | 05 | SC | MEDICAID |